Healthcare Provider Details

I. General information

NPI: 1992953053
Provider Name (Legal Business Name): HARRIS WESTPLEX TAXI & PERSONAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 BUCKNER RD
WENTZVILLE MO
63385-5406
US

IV. Provider business mailing address

584 BUCKNER RD
WENTZVILLE MO
63385-5406
US

V. Phone/Fax

Practice location:
  • Phone: 636-327-8917
  • Fax: 636-639-6913
Mailing address:
  • Phone: 636-327-8917
  • Fax: 636-639-6913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. DOROTHY L HARRIS
Title or Position: PRESIDENT
Credential:
Phone: 636-327-8917